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Postpartum Depression: More Common Than You Know

New mothers with postpartum depression can feel very alone. But at least 20% of new mothers experience it. Here's how to cope.

Postpartum Depression vs. Postpartum Psychosis continued...

About one in every 1,000 new mothers develops postpartum psychosis, compared to the one in five who goes through other perinatal mood disorders. It comes on "very shortly after delivery, within the first 72 hours to the first couple of weeks," says Gunyon Meyer. "Often the first sign is that the mother is speeded up, not sleeping, and yet she feels great. Then she'll be having these unusual thoughts about harming the baby or 'protecting' the baby from evil by harming him or her. Sometimes these thoughts will wax and wane a little, so she thinks it's going away and doesn't tell anyone until she has a true psychotic break."

Both women with postpartum depression and women with postpartum psychosis have thoughts about hurting the baby, but the difference is that women with postpartum depression, like Garman, are horrified by these thoughts, while women with postpartum psychosis think they're normal. With postpartum depression, "acute depression and anxiety develop in ways that make women feel as if they're going mad," Kleiman says. "They don't realize that having these thoughts doesn't mean they're going to act on them. The thoughts are horrible and scary, but the good news is that they do scare you. Women with postpartum depression don't hurt their children. In fact, they'll go to extreme lengths to protect their children, even hurting themselves to avoid harming their child."

Treating Postpartum Depression

True postpartum psychosis requires intensive treatment and often hospitalization. But most women with postpartum depression and other perinatal mood disorders can find relief relatively quickly with treatments that usually include some combination of medication and counseling. In therapy, women learn specific techniques to quell persistent anxiety and rid themselves of intrusive thoughts about harm coming to their baby.

Women are also encouraged to find a way to take care of themselves, not just the baby. "You're a pitcher of water, and if you're always giving, you're going to be empty. How do you fill back up?" Gunyon Meyer asks. "Make sure you'll have time to go to the gym or even just the grocery store alone."

Antidepressants are another element of treatment for some women. Many worry about taking antidepressants, especially if they are nursing, because medication does get into breast milk. But most experts say those fears are generally exaggerated. "Though nothing is ever 100% risk-free, we do have studies that show no long-term adverse effects from taking antidepressants while breastfeeding," Gunyon Meyer says. On the other hand, she points out, numerous studies show how being severely depressed or anxious while pregnant or breastfeeding can have a negative effect on the baby.

Garman and Merritt, much like most of the women who come to the support group Gunyon Meyer runs, took medication in addition to counseling. Garman benefited from a program developed by her health insurance company, Medical Mutual. When a routine follow-up call the company makes to check on moms revealed signs of postpartum depression, the insurer alerted Garman's doctor, who called to intervene. She spent three months on a low dose of an antidepressant and had weekly calls with a social worker provided by her insurance company.

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